Sports Medicine Teacher Flashcards

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Sports Medicine

Teacher Flashcards
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How are sports injuries classified How are sports injuries classified
and managed? and managed?
Ways to classify sports injuries Ways to classify sports injuries
Direct and indirect

How are sports injuries classified How are sports injuries classified
and managed? and managed?
Ways to classify sports injuries Ways to classify sports injuries
Soft and hard tissue Overuse

How are sports injuries classified How are sports injuries classified
and managed? and managed?
Soft tissue injuries Soft tissue injuries
Tears, sprains, contusions

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Direct and indirect
Direct injury occurs at the sight where an external
force made contact with the athlete.

– E.g. A bruise on the thigh where a cricket


ball made contact. Ways to classify sports injuries
 Direct and indirect
Indirect injury occurs as a result of internal forces  Soft and hard tissue
(in the body), either transmitted from external to  Overuse
another part of the body OR produced by muscles.

– E.g. A football player falls over landing on


their hand, the force travels up their arm and
dislocates their shoulder, OR a sprinter is
racing and strains their hamstring.

Soft and hard tissue


Overuse
Soft tissue injuries occur to any tissue in the body
Overuse injuries are caused by repeated movement
other than teeth or bone.
causing minor injuries that do not recover before re-
injury. This produces scar tissue and can lead to
– E.g. sprained ankle, or a skin abrasion.
greater injury.
Hard tissue injuries occur to teeth or bone.
– E.g. Tendonitis
– E.g. a broken tooth, or a dislocated patella.

Tears, sprains, contusions


Tears AKA strains, occur in muscles and have 3
classifications: 1st – small tear, 2nd – partial tear, 3rd
– complete tear.

– E.g. a torn pectoral muscle


Soft tissue injuries
Sprains occur in ligaments and have 3  tears, sprains, contusions
classifications: 1st – small tear, 2nd – partial tear, 3rd  skin abrasions, lacerations, blisters
– complete tear.  inflammatory response
– E.g. sprained ankle

Contusion is when capillaries are ruptured causing


internal bleeding.

– E.g. a bruise

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How are sports injuries classified How are sports injuries classified
and managed? and managed?
Soft tissue injuries Soft tissue injuries
Skin abrasions, lacerations, blisters Inflammatory response

How are sports injuries classified How are sports injuries classified
and managed? and managed?
Soft tissue injuries Hard tissue injuries
Treatment

How are sports injuries classified How are sports injuries classified
and managed? and managed?
Hard tissue injuries Hard tissue injuries
Fractures Dislocation

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Skin abrasions, lacerations, blisters
Skin abrasion is a scraping or wearing away of the
skin and is usually not very deep.
– E.g. a grazed knee from a slide tackle in
Inflammatory response
soccer
Vasodilation increases the fluid flow into the injured
area delivering white blood cells and nutrients
A laceration is a deep cut or tear to the skin of
needed for repair. Has 3 phases: Acute – high
resulting from contact with a sharp device.
inflammation, 48-72 hrs RICER is important; Repair
– E.g. an ice-hockey player who gets hit with
– begin to fix damaged cells, scar tissue developed
a stick cutting his skin open.
3d-6wks; remodelling – continued rebuilding of cells,
scar tissue converted to body tissue, months.
A blister is caused by friction or burning that leads
to a build-up of serum in the skin.
– E.g. blister from the wrong sized shoe

Treatment of soft tissue injuries


Treatment for skin control bleeding, wash, dry and
Hard tissue injuries cover for infection control and to help minimize
 fractures bleeding. Don’t pop a blister.
 dislocation
Rest, Ice, Compression, Elevation, Referral for all
soft tissue injuries to reduce inflammation and
promote healing.

Fractures
Dislocation A fracture is a broken bone. Closed remains inside
An abnormal separation in a joint between 2 bones. the body, open pierces the skin, Complicated the
It causes damage to surrounding tissue such as bone causes further damage. Complete fracture
ligaments. breaks clean through the bone, an incomplete or
greenstick does not, comminuted result in more
– E.g. a dislocated shoulder (humerous separates than 2 parts to the bone.
from scapula).
– E.g. a closed complete fracture of the humerous.

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How are sports injuries classified How are sports injuries classified
and managed? and managed?
Hard tissue injuries Assessment of injuries
Management

How does sports medicine


How are sports injuries classified
address the demands of specific
and managed?
athletes?
Assessment of injuries
TOTAPS Children and young athletes

How does sports medicine How does sports medicine


address the demands of specific address the demands of specific
athletes? athletes?
Children and young athletes Children and young athletes
Medical conditions Overuse injuries

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Management of hard tissue injuries
Hard tissue injuries require fast assessment
following DRSABCD and TOTAPS. Once identified
Assessment of injuries medical attention is required. First aid treatment is
 TOTAPS (Talk, Observe, Touch, Active to immobilise the area/limb.
and Passive movement, Skills test).
– E.g. A broken arm should be placed in a sling and
assessed by a medical practitioner, including X-
rays, and a possible cast or surgery.

TOTAPS
To assess injuries DRSABCD and then TOTAPS is
followed. Once it is evident that the athlete cannot
continue to perform TOTAPS is stopped and the
athlete removed from play. If the athlete completes
Children and young athletes TOTAPS pain-free they can continue to perform.
 medical conditions (asthma, diabetes,
epilepsy) – E.g. An athlete with a sore ankle has DR
 overuse injuries (stress fractures) completed, then is asked about the injury (how?
 thermoregulation What? Where? Pain level? Sounds?). The ankle
 appropriateness of resistance training is observed and compared to the other, before it
is touched (heat, tenderness, pain), active
(athlete moves), passive (assessor moves),
skills test (walk, run, change direction, jump etc)
before allowed to return. STOP TOTAPS if pain
or decreased ROM etc.

Medical Conditions
Asthma is inflammation and contraction of the
Overuse injuries bronchioles. Exercise can induce an attack. It
Overuse injuries result from repetitive movements should not affect participation. Management proper
placing repetitive stress upon the body parts warm up, asthma management plan, and First Aid.
involved. Common injuries include: stress
fractures, shin splints and tendonitis. Implications Diabetes is a condition of poor insulin efficiency, or
varied sports participation, adequate rest and lack of insulin production to control blood sugar
recovery. Management means stopping the activity levels. Implications timing and use of insulin will
until fully recovered, and is done in conjunction with vary with physical activity. It should not limit
health professionals. engagement. Management hypoglycaemia requires
sugary drink/food, while hyperglycaemia requires
– E.g. child with a stress fracture in their shin needs insulin.
to rest from running until cleared by GP.
Epilepsy disruption to normal brain activity that
causes seizure. Implications should not affect
participation in general. Management medications
used and supervision.

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How does sports medicine How does sports medicine
address the demands of specific address the demands of specific
athletes? athletes?
Children and young athletes Children and young athletes
Thermoregulation Appropriateness of resistance training

How does sports medicine How does sports medicine


address the demands of specific address the demands of specific
athletes? athletes?
Adult and aged athletes Adult and aged athletes
Heart conditions

How does sports medicine How does sports medicine


address the demands of specific address the demands of specific
athletes? athletes?
Adult and aged athletes Adult and aged athletes
Fractures/ bone density Flexibility/ joint mobility

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Thermoregulation
Thermoregulation is maintaining body temperature.
Appropriateness of resistance training
Physical activity produces heat as a by-product. It is
Resistance training is recommended for children
underdeveloped in children and young athletes.
and young athletes. It is no more dangerous than
Small surface area to body mass ration means they
other forms of physical activity and does not stunt
are more affected by the environment. Implications
growth. Implications and management for children
include: appropriate clothing, time of day the sport is
and young athletes should be properly supervised,
played, availability of shade, and access to fluid.
and be taught technique as 1st priority. Guidelines
Management hyperthermia cool down using fans,
should be followed.
remove clothing, in shade etc. Hypothermia, warm
up using blankets, remove wet clothing.
– E.g. A 12-year-old child does training with a
personal trainer using the ASCA guidelines for
– E.g. Football in 36 degree day requires drink
intensity.
breaks every 10 min, played in the morning or late
afternoon, with first aid for hyperthermia available.

Heart conditions
Heart conditions include hypertension, CVD, valve
issues etc. They will need a medical clearance
Adult and aged athletes
before beginning physical activity, which is
beneficial for them. Participation options lower  heart conditions
intensity sports, intensity can build up slowly under  fractures/bone density
proper supervision (health professional).  flexibility/joint mobility

– E.g. walking that increases to jogging.

Flexibility/ joint mobility Fractures/ bone density


Flexibility is joint specific and refers to the joint Facture is a broken bone and poor bone density,
range of motion/movement. Elderly and aged such as osteoporosis, leads to bones breaking more
athletes with poor flexibility should develop their easily. Participation options are limited, contact
flexibility before participating in sports that require sports and other sports with high impact or
flexibility, especially gymnastics and dance. frequency of injury should be avoided to prevent
Increased flexibility helps to prevent injury in sports fractures. Physical activity is good for increasing
like football (soccer). bone density, particularly resistance training.

– E.g. beginners Yoga progressing to intermediate – E.g. swimming is a low impact sport for people
etc. with low bone density.

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How does sports medicine How does sports medicine
address the demands of specific address the demands of specific
athletes? athletes?
Female athletes Female athletes
Eating disorders

How does sports medicine How does sports medicine


address the demands of specific address the demands of specific
athletes? athletes?
Female athletes Female athletes
Iron deficiency Bone density

How does sports medicine What role do preventative


address the demands of specific actions play in enhancing the
athletes? wellbeing of the athlete?
Female athletes Physical preparation
Pregnancy

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Eating disorders
Eating disorders come from social pressures and
include anorexia, bulimia etc. They cause a lack of
nutrition and result in poor recovery and a lack of
Female athletes
physiological adaptations. This, in turn, leads to
 eating disorders
injuries and can stop menstruation. Athletes can
also become iron deficient leading to lethargy and  iron deficiency
poor performance.  bone density
 pregnancy
– E.g. Female athlete has anorexia, becomes Iron
deficient due to lack of iron consumption. They then
stop menstruation and have poor athletic
performance.

Iron deficiency
Bone density
Iron deficiency results from loss of iron during
Bone density is the number of minerals per square
menstruation and a lack of iron in the diet. Iron
cm of bone. Poor bone density leads to fragile
deficiency affects participation in sport by
bones and increases the likelihood of fracture. This
decreasing aerobic performance (lack of
makes is less safe for the athlete to participate in
haemoglobin), causing faster fatigue and lethargy in
high impact sports.
the athlete.
– E.g. Female athlete has a poor diet, leading to a
– E.g. female athlete does not eat enough iron and
lack of calcium causing poor bone density. They
increases their marathon time due to a lack of
then suffer a stress fracture from netball and need
haemoglobin. They are also lethargic and miss
to stop playing.
training.

Pregnancy
A pregnant athlete can continue to do sports they
already do. Increased relaxin means care should be
taken not to overstretch a joint. Care should also be
Physical preparation
taken in relation to balance with the change in the
 pre-screening
centre of gravity as the baby grows. Physical activity
 skill and technique benefits pregnancy, though the heat of the day
 physical fitness should be avoided to avoid overheating.
 warm up, stretching and cool down
– E.g. a pregnant marathon runner, can continue to
train and perform, but may choose to avoid training
in the heat. They may also choose to not do
gymnastics due to changes in CoG.

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What role do preventative What role do preventative
actions play in enhancing the actions play in enhancing the
wellbeing of the athlete? wellbeing of the athlete?
Physical preparation Physical preparation
Pre-screening Skill and technique

What role do preventative What role do preventative


actions play in enhancing the actions play in enhancing the
wellbeing of the athlete? wellbeing of the athlete?
Physical preparation Physical preparation
Physical fitness Warm up, stretching and cool down

What role do preventative What role do preventative


actions play in enhancing the actions play in enhancing the
wellbeing of the athlete? wellbeing of the athlete?

Sports policy and the sports Sports policy and the sports
environment environment
Rules of sports and activities

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Pre-screening
Skill and technique
Before beginning new exercise programs people
High-level skill and good technique help prevent
undergo a pre-screening questionnaire to help
injury and enhance the well-being of the athlete.
determine the level of fitness and health. If they fail
Technique particularly helps avoid overuse injuries
the pre-screening they get clearance from a GP
and improves movement efficiency.
before commencing.
– E.g. football player with poor skill steps on the ball
– E.g. A 40-year-old with CVD fails pre-screening
and sprains his ankle. Or a cricket bowler twists
because it is not safe to begin exercise without
wrong when bowling and injuries his back.
medical clearance.

Warm up, stretching and cool down


Warm up prepares the body for activity getting
blood to the right muscles and the body doing
movements used in competition.
Physical fitness
– E.g. cricket player warms up by running, bowling,
Each sport has specific components of fitness that
catching etc before taking the field to help prevent a
are dominant. If an athlete is lacking in any of these
hamstring strain while bowling.
compared to their level of performance then injury is
more likely.
Stretching as a routine helps increase flexibility and
reduce injury from overstretching.
– E.g. A netball player with poor muscular
– E.g. A rugby player who is flexible is less likely to
endurance will fatigue faster and becomes more
get injured when twisted in a tackle.
likely to use poor technique when changing direction
Cool down helps to prevent blood pooling and and injure their ankle.
helps remove waste products.
– E.g. Cool down after a marathon helps to remove
waste products and improve recovery.

Rules of sports and activities


Sports policy and the sports environment
The rules of sports and activities are designed
 rules of sports and activities
specifically for the sport or activity in order to
promote safety and the well-being of the athlete.  modified rules for children
They promote fair play.  matching of opponents, eg growth and
development, skill level
– E.g. the “crouch-touch-pause-engage” rule for  use of protective equipment
rugby union scrums was introduced in order to, and  safe grounds, equipment and facilities
does reduce neck injuries.

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What role do preventative What role do preventative
actions play in enhancing the actions play in enhancing the
wellbeing of the athlete? wellbeing of the athlete?
Sports policy and the sports Sports policy and the sports
environment environment
Modified rules for children Matching opponents

What role do preventative What role do preventative


actions play in enhancing the actions play in enhancing the
wellbeing of the athlete? wellbeing of the athlete?
Sports policy and the sports Sports policy and the sports
environment environment
Use of protective equipment Safe grounds, equipment and facilities

What role do preventative What role do preventative


actions play in enhancing the actions play in enhancing the
wellbeing of the athlete? wellbeing of the athlete?
Environmental considerations Environmental considerations
Temperature regulation

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Matching of opponents Modified rules for children
Opponents in sport need to be matched by Rules of sports are often modified in order to
combining ability, size, age and/or sex. Matching of promote safety and participation for children.
opponents should be done in a manner that Competition is often shorter and played on smaller
promotes athlete wellbeing and safety. fields and allows for a greater rotation of players.

– E.g. Kung Fu matched by age or weight, sex and – E.g. Football reduces games to 30min, size 3 ball
belt. and 30m x 20m fields.

Safe grounds, equipment and facilities


Grounds must be safe, flat and predictable, to
prevent injury.
– E.g. rugby player rolls his ankle in a divot on the Use of protective equipment
field. Protective equipment is mandatory in many sports,
and optional in others. They promote safety
Equipment needs to be well maintained and particularly from collision or being hit by an object.
working in order to prevent injury. Incorrect or poor Some equipment is not worn.
equipment can easily result in injury.
– E.g. old shoes don’t absorb force, leading to – E.g. batters in cricket wear helmets to protect their
stress fractures in the tibia. head from being hit by the cricket ball, which can
cause serious head injury AND post in rugby league
Facilities need to cater for events held on the have padding to prevent players being tackled into
grounds to promote safety. the metal post.
– E.g. swimming pools should have non-slip
surfaces around the pool, or shade at a cricket
ground for the batting team

Temperature regulation
Convection is heat transferred by the motion of a
fluid, such as air or water, taking the heat with it.
– E.g. pouring water over the skin is a useful
strategy
Environmental considerations
Radiation is the transfer of energy in the form of  temperature regulation (convection,
electromagnetic waves. radiation, conduction, evaporation)
– E.g. exposing the athlete to the sun for heat.  climatic conditions (temperature, humidity,
wind, rain, altitude, pollution)
Conduction the transfer of heat between two (2)  guidelines for fluid intake
objects in contact with each other.  acclimatisation
– E.g. wearing an ice-vest on a hot day.

Evaporation the transfer of heat, to water (sweat),


resulting in the fluid becoming a vapour.
– E.g. Drinking plenty of fluid to allow increased
sweat, while avoiding dehydration

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What role do preventative What role do preventative
actions play in enhancing the actions play in enhancing the
wellbeing of the athlete? wellbeing of the athlete?
Environmental considerations Environmental considerations
Climatic conditions Climatic conditions
(Temperature) (Humidity)

What role do preventative What role do preventative


actions play in enhancing the actions play in enhancing the
wellbeing of the athlete? wellbeing of the athlete?
Environmental considerations Environmental considerations
Climatic conditions Climatic conditions
(Wind) (Rain)

What role do preventative What role do preventative


actions play in enhancing the actions play in enhancing the
wellbeing of the athlete? wellbeing of the athlete?
Environmental considerations Environmental considerations
Climatic conditions Climatic conditions
(Altitude) (Pollution)

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Climatic conditions Climatic conditions
Humidity decreases the body’s ability to use Temperature heat increases the likelihood of
evaporation to cool. When combined with heat hyperthermia or heat stroke and can be dangerous.
greatly increases the likelihood of hyperthermia or Cool temperatures can cause hypothermia. These
heat stroke. need to be prevented by assisting the temperature
regulation mechanisms in maintaining body
– E.g. marathon runner on a hot humid day may use temperature.
of an ice-vest to keep the body cool.
. – E.g. drinking more in the heat or wearing snow
jackets when snowboarding.

Climatic conditions
Rain removes heat from the body through both Climatic conditions
conduction (heat moving to the water) and Wind removes heat from the body using convection.
evaporation. When it is hot rain is a welcome way to When combined with cool conditions the amount of
cool down, but when combined with cool weather heat removed increases the likelihood of
and/or wind this increases the likelihood of hypothermia. Appropriate clothing can help to
hypothermia dramatically. Appropriate clothing can reduce the heat loss.
help reduce the heat lost in such conditions.
– E.g. players wearing windbreakers (jacket) during
- E.g. wearing a waterproof jacket when going for a their warm up.
run in the rain when it is cold.

Climatic conditions
Altitude affects the oxygen concentration in the air.
Climatic conditions The higher we go, the lower the concentration. If an
Pollution is dangerous for the athlete because they athlete is not acclimatised beforehand their
breathe more deeply during a performance, performance will decrease, but they also run the
increasing the pollution inhaled that affects their danger of becoming hypoxic (not enough oxygen)
health, both in the short and long term. and feel dizzy, nauseous or worse.

– E.g. An athlete running a marathon in pollution – E.g. a skier starts at the top of a mountain but
may get a chest infection from the pollution. becomes hypoxic, losing balance and crashing
requiring emergency assistance to be taken down
the mountain and treated for hypoxia.

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What role do preventative What role do preventative
actions play in enhancing the actions play in enhancing the
wellbeing of the athlete? wellbeing of the athlete?
Environmental considerations Environmental considerations
Guidelines for fluid intake Acclimatisation

What role do preventative What role do preventative


actions play in enhancing the actions play in enhancing the
wellbeing of the athlete? wellbeing of the athlete?
Taping and bandaging Taping and bandaging
Preventative taping

What role do preventative What role do preventative


actions play in enhancing the actions play in enhancing the
wellbeing of the athlete? wellbeing of the athlete?
Taping and bandaging Taping and bandaging
Taping for isolation of injury Bandaging for immediate treatment of injury

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Acclimatisation
Guidelines for fluid intake
Acclimatisation is when an athlete adjusts to a
An athlete needs to be appropriately hydrated
change in environment (such as a change in
before a performance. During a performance,
temperature, humidity, or altitude), allowing them to
frequent small amounts is best. After a
maintain performance in the new environmental
performance, the athlete should rehydrate replacing
conditions. It is needed for any changes in climatic
fluids lost.
conditions: hot, humid, cold, wind, rain and altitude,
and takes around 2 weeks (longer for children).
– E.g. A marathon runner drinks 500mL 4 hrs before
event, then 300mL 15 min before. During the event
– E.g. a footballer needing to compete at high
they consume 150mL every 15-20min and
altitude will travel to the location 2-3 weeks prior to
afterwards drink 1.5L for very 1Kg of weight lost to
the event to avoid hypoxia and to increase
replace fluid loss.
haemoglobin levels.

Preventative taping
Preventative taping is when the athlete tapes a joint,
such as the ankle, in order to prevent injury from
occurring. Athletes who use preventative taping
often have a history of injury in the joint taped. It Taping and bandaging
works by providing feedback to the athlete by pulling  preventative taping
not the skin when the tap is stretched. Long-term  taping for isolation of injury
taping can decrease the strength of the joint and  bandaging for immediate treatment of
affect the athlete’s proprioception negatively. injury.
However, taping decreases the rate of injury in
those who use it.

– E.g. a netballer with a history of sprained ankles


may tape her ankles to prevent re-injury.

Taping for isolation of injury


Taping for isolation of injury is reduces pain during
Bandaging for immediate treatment of injury exercise and prevents further injury. It limits the
Bandaging for treatment of injury is part of RICER range of motion, stabilizes the joint, reduces
and plays an important role in helping to decrease inflammation and provides feedback. However,
bleeding and inflammation, while also providing some people react to the tape or find it irritates their
support, especially if the injury is at a joint. It should skin. Taping does reduce re-injury and further injury
allow for regular muscle contraction and a fair range and is used to treat injury to reduce inflammation
of motion to promote rehabilitation. and bleeding.

– E.g. a cricket player bandages his wrist after – E.g. a rugby player with an injured shoulder will
spraining it in the field to help promote healing and tape the shoulder to help limit the range of motion,
prevent further injury. and provide extra stability in as they begin to return
to training.

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How is injury rehabilitation How is injury rehabilitation
managed? managed?
Rehabilitation procedures Rehabilitation procedures
Progressive mobilisation

How is injury rehabilitation How is injury rehabilitation


managed? managed?
Rehabilitation procedures Rehabilitation procedures
Graduated exercise Training

How is injury rehabilitation How is injury rehabilitation


managed? managed?
Rehabilitation procedures Return to play
Use of heat and cold

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Progressive mobilisation
Progressive mobilisation slowly stretches the
Rehabilitation procedures
muscles allowing for a gradual increase in the range
 progressive mobilisation
of motion at the joint. This begins as early as
possible and uses a range of different types of  graduated exercise (stretching,
stretching, but not ballistic. conditioning, total body fitness)
 training
– E.g. after a hamstring tear and athlete will slowly  use of heat and cold
increase the range of motion at the hip and knee by
stretching their hamstring.

Graduated exercise
It is used in rehabilitation to ensure exercise
Training intensity and activities progress with healing and do
Training during rehabilitation helps to prevent not cause further injury. It is the gradual increase in
reversibility. Training should use the non-injured range of motion, intensity, and activities, to help
areas when possible. Athletes should return to light ensure the athlete’s recovery is as pain-free as
and then full training and show they have recovered possible. There are three (3) stages – stretching,
before returning to play. then conditioning, then total body fitness – these
stages overlap.
– E.g. a rugby player returning from a dislocated
shoulder can maintain lower body training while – E.g. after a shoulder dislocation a rower will
resting the shoulder. They then return to light stretch their rotator cuff muscles slowly increasing
training progressing to full training, including the ROM, strengthen the rotator cuff slowly
repeated tackling showing they have fully recovered increasing the workload, maintain fitness using an
before returning to play. exercise bike, as recovery progresses move into
low-intensity shoulder exercises progressing to
higher intensities. Then move into developing total
body fitness using a rowing machine.
Use of heat and cold
Heat is used to increase blood flow and flexibility
around the injured area. This helps speed up
Return to play recovery delivering nutrients for rebuilding damaged
 indicators of readiness for return to play tissue and helping rehabilitation activities.
(pain free, degree of mobility) – E.g. heat pack applied to a sprained ankle 3
 monitoring progress (pre-test and post-test) weeks after injury in order to increase ROM and
 psychological readiness deliver blood for rebuilding.
 specific warm-up procedures
 return to play policies and procedures Cold is used to decrease blood flow and
 ethical considerations, eg pressure to inflammation. It is used particularly in the first 48 hrs
participate, use of painkillers. after injury and any other time inflammation may
occur (after rehabilitation session).
– E.g. ice pack applied to a strained hamstring after
a rehabilitation session to reduce inflammation.

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How is injury rehabilitation How is injury rehabilitation
managed? managed?
Return to play Return to play
Indicators of readiness for return to play Monitoring progress

How is injury rehabilitation How is injury rehabilitation


managed? managed?
Return to play Return to play
Psychological readiness Specific warm-up procedures

How is injury rehabilitation How is injury rehabilitation


managed? managed?
Return to play Return to play
Return to play policies and procedures Ethical considerations

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Monitoring progress
Throughout rehabilitation, progress is monitored
Indicators of readiness for return to play
through testing. The results of testing are compared
In order to be ready to return to play the athlete’s
with pre-injury tests in order to determine readiness
injured area need to have returned to normal or pre-
for return to play. After rehabilitation, an athlete
injury levels of mobility. This mobility needs to be
should return to pre-injury test results, or a pre-
pain-free when performing normal activities in the
determined level that is appropriate for their level of
sport.
competition.
– E.g. a football player has full mobility and is pain-
– E.g. A netball player achieves similar results in
free when sprinting, changing direction, kicking a
their pre- and post-fitness tests such as T shuttle
ball, protecting a ball, jumping etc.
agility test, beep test, and other netball specific
tests.

Psychological readiness
Specific warm-up procedures Athletes can feel anxious after injury and
A specific warm-up is given in addition to the normal rehabilitation and lack confidence in the injured
warm-up and can be done before or after this. It area. If an athlete is not psychologically ready they
helps to protect the athlete against re-injury by will shield the injured area, which can affect
ensuring the area has an adequate blood supply technique and cause other or further injury. An over-
and is ready for competition. confident player may reinjure the area by returning
to quickly
– E.g. after a hamstring tear an ice-hockey player is .
given a lower limb sports massage to help avoid re- – E.g. after a knee reconstruction a rugby player
injury. shields his knee always tackling using his other leg,
leading to injury to the other knee.

Ethical considerations Return to play policies and procedures


Athletes are under pressure to return to play as fast Each sports code has their own return to play
as possible, which can lead some to return before policies and procedures that need to be followed
they are ready. This includes external pressures before an athlete in the sport can return to
form the coach and internal pressures from wanting competition. Not all sports are the same because
to maintain a place on the field. This pressure can sports place different demands on the athlete. The
lead athletes to use painkillers to mask pain so that final say usually lays with the athlete, though the
they can return o play or continue to play when coach and medical professionals are also involved.
injured, this should not be allowed. Most protocols involve scans, medical and other
professional clearances along with fitness tests.
– E.g. A NFL quarterback returns early from a
shoulder dislocation using painkillers to mask the – E.g. a boxer who is knocked out cannot return to a
pain because his team is losing without him and his ring for a minimum of 28 days to prevent re-injury
teammates are pressuring him to return. and permanent brain damage.

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